Department of Cardiovascular Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan.
Department of Internal Medicine, Kansai Medical University Kori Hospital, Neyagawa, Japan.
J Clin Hypertens (Greenwich). 2024 Oct;26(10):1196-1200. doi: 10.1111/jch.14900. Epub 2024 Sep 9.
The authors investigated the antihypertensive effect of sacubitril/valsartan (Sac/Val) when switching from other drugs and assessed whether brain natriuretic peptide (BNP) or plasma renin activity (PRA) before drug switching was a predictor of blood pressure lowering after switching to Sac/Val. In 92 patients with treated hypertension, clinic blood pressure, plasma BNP, and PRA were examined before and after switching to Sac/Val. Clinic systolic and diastolic blood pressures significantly decreased after drug switching to Sac/Val (p < .0001, respectively). The level before drug switching of BNP had no correlation with the change in systolic blood pressure (Δ-SBP) before and after switching to Sac/Val, but that of PRA was significantly correlated with Δ-SBP (r = .3807, p = .0002). A multiple regression analysis revealed that PRA before drug switching was an independent determinant of Δ-SBP. Our findings suggest that low PRA may become a useful marker to predict the antihypertensive effect of switching to Sac/Val in treated hypertensive patients.
作者研究了从其他药物转换为 sacubitril/valsartan（Sac/Val）时的降压效果，并评估了药物转换前脑钠肽（BNP）或血浆肾素活性（PRA）是否可以预测转换为 Sac/Val 后血压降低的情况。在 92 例接受治疗的高血压患者中，在转换为 Sac/Val 前后检查了诊室血压、血浆 BNP 和 PRA。转换为 Sac/Val 后，诊室收缩压和舒张压均显著降低（分别为 p < 0.0001）。药物转换前 BNP 水平与 Sac/Val 前后收缩压变化（Δ-SBP）之间无相关性，但 PRA 与 Δ-SBP 显著相关（r = 0.3807，p = 0.0002）。多元回归分析显示，药物转换前的 PRA 是 Δ-SBP 的独立决定因素。我们的研究结果表明，低 PRA 可能成为预测接受治疗的高血压患者转换为 Sac/Val 的降压效果的有用标志物。
